**5.3 Psychopharmacology**

*Anxiolytics:* Benzodiazepines are used successfully in the treatment of common anxiety disorders. It can be prescribed when the patient is particularly anxious. Alprazolam, lorazepam and clonazepam are particularly effective in treating panic disorder. In Benzodiazepine *treatment*, there are physical addiction and tolerance risks that can lead to addiction. This is because deprivation symptoms can be life-threatening, so patients should be warned against sudden termination of drug intake, and drug termination should be done with treatment. Due to potential for addiction, benzodiazepines, SSRIs, serotonin, and norepinephrine reuptake inhibitors (SNRs), and buspirone are the first-line therapy [27].

Buspirone, which as an anti-anxiety agent, is effective in approximately 60% to 80% of patients with a generalized anxiety disorder [3]. The only disadvantage of buspirone is the 10-14 day delay in relieving symptoms. However, the lack of physical addiction and tolerance disadvantage of buspirone makes it the drug of choice in the treatment of generalized anxiety disorders. The effects and side effects of anxiolytic agents are given in **Table 2**.

*Antidepressants:* Many antidepressants are as effective as anti-anxiety agents. Tricyclic, clomipramine and imipramine drugs are used successfully in patients with panic disorder. However, after the discovery of SSRIs, tricyclics are used less frequently because they tend to cause side effects when given in desired high doses to alleviate panic disorder symptoms [15].


**Table 2.**

*Anxiolytic agents.*

SSRIs are effective in treating panic disorders. Paroxetine, fluoxetine, and sertraline have been approved by the US Food and Drug Administration (FDA) for these purposes. The dosage of these drugs should be increased gradually, as patients with panic disorder are sensitive to overstimulation caused by SSRIs [1].

The use of anti-depressants in the treatment of generalized anxiety disorders is still under investigation. Some success has been reported with tricyclic, imipramine and SSRI drugs. The FDA has approved paroxetine, escitalopram, duloxetine and extended-release venlafaxine for the treatment of generalized anxiety disorders [28].

Beta blockers: Clonid and beta-blockers such as propranolol and atenolol are also used especially in maintenance treatment. These drugs are most effective in treating state anxiety [1].

## **Author details**

Hülya Kök Eren

Department of Mental Health and Diseases Nursing, Faculty of Health Sciences, Eskisehir Osmangazi University, Turkey

\*Address all correspondence to: hulyakok2911@gmail.com

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

**91**

*Anxiety Disorders*

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